Microbial Storms
A 2013 book charts the rise of the biosecurity state and anticipates the dystopian world of COVID-19
In Men, Women: A User’s Manual, a Claude Lelouch film, a wealthy swashbuckling businessman troubled by abdominal pain goes to a Parisian hospital for an examination. Suddenly confronted with his own mortality, the otherwise optimistic businessman ruminates on one’s destiny. The worst, he tells the examining doctor, never disappoints (“Le pire n’est jamais décevant”). But the businessman is too sanguine by temperament to dwell on the worst. Striking up an acquaintanceship with another patient in the waiting room — a struggling actor and inveterate worrywart also beset by stomach trouble — he tells his new pal as the two leave the hospital that, though the worst might never disappoint, it is also never certain (“Le pire n’est jamais certain”).
I often thought of that movie while reading Tempêtes Microbiennes. Essai sur la politique de sécurité sanitaire dans le monde transatlantique (Microbial Storms. An Essay on Health Security in the Transatlantic World — all translations are my own unless indicated otherwise). Written by Patrick Zylberman, a French professor of health history, the book seems to have attracted limited attention among the general public, sufficiently limited that it has yet to see an English translation. That is a pity. Published seven years before the COVID-19 pandemic, Tempêtes Microbiennes anticipates the nightmarish global response to COVID-19 and goes a long way towards explaining how we’ve got to where we are now.
First, a little bit of history from Zylberman. Hard as it might be to believe this today, by the late 1970s the civilized world had come to feel decidedly pollyannish about infectious diseases. With the development and extensive use of vaccines and antibiotics, and the taming or complete eradication of various diseases (countries such as Italy were able to entirely rid themselves of malaria, while in 1979 smallpox was declared to have been eradicated), many thought that human civilization had vanquished the transmission of pathogens. Budgets were cut, and an almost Fukuyamesque sense of the end of history seemed to prevail. It was hardly the best time to be an infectious diseases specialist.
By the turn of the century, everything had changed.
What had changed, exactly? Several things. First, the HIV/AIDS epidemic in the 1980s had put paid to the idea that plagues were a thing of the past. Second, terrorism — or rather, the nature of terrorism — had evolved. Whereas terrorists had had clearly defined objectives in the past, terrorist threats now also came from apocalyptic sects and solitary individuals whose goal was to produce as much carnage as possible, threats that were underscored by the 1995 sarin attack in the Tokyo subway, the Oklahoma bombing in that same year, and the 2001 anthrax attacks. Third, the collapse of the USSR and the resulting quasi-anarchic state of post-Soviet space had raised concerns about lax security standards at Russian labs that performed research on dangerous viruses and bacteria, and the risk of “brain drain” involving underpaid scientists willing to sell their expertise to unsavory actors. These developments would be further reinforced by such health crises as the SARS outbreak and the heat wave in France that would kill thousands of people in the summer of 2003.
All of this had caused a radical shift in the thinking of governments and policymakers. Biological threats, natural or manmade, were now increasingly seen as a security issue, and public health had gradually begun to be integrated into national security. Health security was becoming central to government policy. As Zylberman writes, this paradigm shift created a framework in which “the politicization of viruses meets the medicalization of warfare.”
The new framework rested on three pillars:
— the use of fictitious scenarios, whose purpose is to prepare for effective governing and administration in emergencies;
— the “logic of the worst,” whereby health policy is formulated based on the worst-case scenario; and
— a “superlative civicism” that requires citizens to act as participants in the execution of health policy, something that involves, among other things, a “doctrine that . . . consists of the absolute supremacy of the protection of public health over that of private life.”
This is exactly our reality today. Since the start of the COVID-19 pandemic, governments have relied on models, projections, and worst-case scenarios to take emergency measures and beef up preparedness for anticipated waves. If the accuracy of these models and projections has been less than stellar, so much the worse for those who have had to submit to the measures — public health has established itself as an absolute concept that supersedes private life.
Additionally, consistent with the framework described by Zylberman, superlative civicism has served as a key tool of health policy throughout the pandemic. Behavioral psychology was applied to get the public to comply with health regulations, and the results must have exceeded all expectations, as many felt emboldened to go beyond self-policing to policing those around them. We have seen people denounce neighbors for having clandestine get-togethers and police chiefs encourage citizens to shame “anti-maskers.” Superlative civicism has become so ingrained I have even observed little children — too young to understand the purpose of masks — reminding their parents to mask up. The now daily baiting and stigmatizing of the unvaccinated is also a form of superlative civicism.
While the goal of this paradigm — keeping society safe — might be praiseworthy, the actual result is what Giorgio Agamben appropriately calls a “sort of ‘health terror’” (Where Are We Now?, Eris, 2021, trans. Valeria Dani). Biopolitics — that is, governmental control of the biological life of the citizenry — becomes the lodestar of government policy, leading to the rise of the biosecurity state in which one’s rights are subservient to considerations of public health, and where individuals are less citizens than agents of contagion who need to be controlled and monitored for their own good. Zylberman writes, “Public health undergoes a hideous metamorphosis, becoming a pure tyranny.” That sounds familiar.
When public health is welded to national security, it is logical that a health care crisis easily turns into a national security crisis. Thus, we currently find ourselves “at war” with a respiratory virus. This is an absurdity if there ever was one, not least because, as a virus needs hosts and everyone is a potential spreader, we are effectively at war with ourselves. In this framework, anyone who opposes measures taken to help us “win the war,” for whatever reasons, is perceived to be helping the enemy. Hence the demonization of those who refuse to stay at home, wear masks, and take the vaccine.
The security measures taken in response to 9/11 — measures pertaining to air travel, for instance — were implemented as part of the war on terror. As the risk of terrorism can never be entirely eliminated, a war on terror is a war that cannot end, which is why the post-9/11 security measures are still in place and can be expected to remain so in perpetuity. Likewise, with the incorporation of public health into national security, measures taken in a health crisis can also be expected to become permanent in some way, since the risk of future pandemics and other crises, health-related or otherwise, will never go away.
When Susan Michie, a behavioral psychologist advising the UK government on the COVID-19 pandemic in her capacity as a member of Sage committee, opined in an interview that social distancing and face masks might stay with us forever in some form, it is unlikely her opinion was influenced by her alleged communist sympathies, as many suggested at the time. Michie was simply expressing a viewpoint that fully conforms to the biosecurity state framework, in which the public lives in a permanent state of high alert. As long as the framework is in place, a full return to normality might be well-nigh impossible.
How does one resist a biosecurity state? Just as superlative civicism is essential to sustaining the biosecurity model, massive civil disobedience will be needed to leave it. For resistance to be successful, the model has to be rejected by broad sections of the public. The real conflict of the microbial storm of our time is not between “maskers” and “anti-maskers,” or between the vaccinated and “anti-vaxxers.” It is between those who are comfortable living in a biosecurity state (either because they have thus far found it tolerable, or because they haven’t yet realized what it is that they have signed up for) and between those who find such a state toxic; between those who put safety, or the illusion thereof, above all else, and those who believe there is more to life than risk management and the avoidance of death.
Zylberman concludes his work by pointing out that, in the existing health security framework, “reality is frightening not because it is real, but because it might become real.” But a reality that has yet to, and may never, become real is not reality. The challenge for those who want to resist the biosecurity model is to convince as much of the public as possible that few are the rewards of living in a society forever on guard against the unreal.
In the French movie I’ve mentioned earlier, both the businessman and the struggling actor fear the worst, the worst being cancer. As it turns out, only the actor is unlucky; the businessman is healthy. Yet the hypochondriacal actor goes on to survive, while the optimistic businessman ends up being killed — in a helicopter crash. The worst, then, does not fail to disappoint, but it makes a mockery of all certainty. The worst is just that — uncertain. It cannot be planned ahead. To accept that is to accept the idea that some element of risk is inevitable, and that a healthy society needs to learn to live with it. Living with some element of risk is not about being reckless, but about putting things into perspective. Given the continued erosion of our rights in the name of public health, perspective is something our society could surely use right now.
